Inspection on 15/05/07 for Howgate House

This inspection was carried out on 15th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Howgate House Howgate Idle Bradford BD10 9RD Lead Inspector Mary Bentley Unannounced Inspection 15 & 30 May 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howgate House Address Howgate Idle Bradford BD10 9RD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01325 351100 01274 610727 howgatehouse@schealthcare.co.uk CC Care Ltd Mrs Shelley Melinda Lobley Care Home 63 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (63), Physical disability (4) Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The PD places are specifically for the service users named in connection with variation applications. The MD place is specifically for the service user named in the application for variation approved 15 December 2005. To add 1 PD named in application dated 10th July 2006. Date of last inspection: N/a – new service. Brief Description of the Service: The home was first registered in 1989, however it was taken over by Southern Cross at the end of last year and was registered as a new service in December 2006. The home provides personal and nursing care for up to sixty-three people. The majority of people living in the home are over the age of 65. Howgate House is a modern purpose built property situated in the village of Idle. It is close to local bus routes and within easy reach of the main road to Leeds and Bradford. Accommodation is provided on 3 floors and many bedrooms have en-suite facilities. There are 8 double rooms. There are communal rooms on the ground and first floors. The ground floor has a separate dining room and lounge and the first floor has a combined lounge and dining room. In preparation for the ban on smoking in public places, which comes into effect in July 2007, the home is planning to create a designated smoking room for people living in the home. There are no gardens, but there is a small patio with outdoor seating. There is some off road parking. In April 2007 the weekly fees ranged from £318.50 to 595.00. Services such as hairdressing and chiropody are available for an additional charge. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I did this unannounced inspection over two days and spent approximately 15 hours in the home. The purpose of the visit was to look at how the needs of people using the service are being met. During the visit I spoke to people who live in the home, visitors, staff and management. I looked at various records relating to care, staff, and maintenance and I looked at some parts of the home. The home completed a pre-inspection questionnaire and the information provided was used during the inspection. Before the visit we sent comment cards to 27 people, (15 to people who live in the home and 12 to relatives). Comment cards give people the opportunity to tell us what they think about the service. The information we get is shared with the home but we do not identify who has provided it. Thirteen comment cards were returned and three people telephoned me to share their views of the service. The information provided has been included in this report. What the service does well: The home is well equipped to meet the needs of people with physical disabilities; it has good access, a passenger lift to all floors and wide corridors. Generally people were happy with the food. One person said, “The home has had the same chef for the duration of my mother’s stay, 2000 – 2007, he is excellent”. The home has just introduced a new menu, which will give people the opportunity to have a lot more home cooked food and a greater variety of fruit and vegetables. The kitchen has been awarded a five star rating (the highest possible) by Environmental Health for the standards of food hygiene and food safety. People are protected by the home’s systems for employing new staff, all the required checks are done before they start work to make sure they are suitable to work with vulnerable adults. Southern Cross provides a good training programme, which means that staff are supported in developing the skills, and knowledge they need to meet people’s needs. The company has good systems for dealing with health and safety and maintenance, which means that the home is a safe place for people to live. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: One person said, “Some thought should be given to getting residents outside, a change of scene or fresh air would help”. This is being dealt with. Some people were not happy with the admission process; they felt it was rushed and they had not been given enough information to make an informed choice. While some people were happy with the care others were not. There were concerns that people’s request for help were not dealt with appropriately, for example people were ignored when they asked for help going to the toilet. People also expressed concerns about the attitudes of some staff, giving examples of staff swearing or speaking over their heads in a language they did not understand. Most people were aware of the home’s complaints procedure but a number of people said the home had not responded appropriately. One person said nothing had been done about a complaint discussed with the manager. A number of people said cleaning could be improved; they mentioned the entrance area and the kitchenettes. A number of people said the home sometimes has an unpleasant odour. A lot of the chairs in the first floor lounge have an unpleasant smell. Some people felt more care should be taken with people’s personal clothing, it is not ironed, and one person said her relatives clothing had been ripped. Please contact the provider for advice of actions taken in response to this Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, & 5. Standard 6 does not apply to this service. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are assessed before they move in. However, more could be done to make sure that people have the information and time they need to make an informed decision about the suitability of the home. EVIDENCE: Four of the five people living in the home who completed surveys said they had been given enough information before they moved in. Six of the eight relatives who responded were not entirely satisfied that they had been given enough information. People are offered the opportunity to visit before making a decision about moving in. However, two groups of relatives I talked to said they had chosen the home in a hurry and had not looked around before admission. One was happy with the choice of home the other was not. Seven of the eight relatives Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 10 who completed surveys did not think the home always met their relatives’ needs. The home has a relatively high number of admissions. This may be creating an approach to new admissions that is more focused on the procedure that on the needs of the person or their representatives. The five people living in the home who completed surveys all said they had a contract. Pre-admission assessments are done before new people move in. Staff said they get information about new people before they move in so they have some understanding of what their care needs will be at the time of admission. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s care needs are not met in a consistent way. This means that some people experience good care while others may have their needs overlooked. EVIDENCE: I looked at the care records of 5 people. Staff at the home have worked hard to transfer all the records to the Southern Cross paperwork. The format is comprehensive and includes detailed assessment information as well as risk assessments for falls, nutrition, pressure sores and moving and handling. There are care plans for personal and health care. Some people have social care plans, for others they are still being developed. Some of the care plans do not provide clear information for staff. This was particularly evident where people were presenting with behaviour that was difficult for the staff to deal with. One person had a particular problem with continence management and the care records did not reflect the difficulties this Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 12 was presenting or provide staff with clear instructions on how they should deal with it. Another person was aggressive to both staff and other people living in the home and there was no care plan to tell staff how to deal with this. Some of the care plans about personal care gave information about weekly baths but did not give any information on the help people needed on a daily basis with their personal hygiene. Three people living in the home said they always get the care and support they need. One relative said, “The care always meets the needs of Mum”. Others said it varied and was not always what they had agreed or expected. Some relatives had concerns that people did not always get the help they needed, when they needed it, particularly when they wanted the toilet. Another person said their relative sometimes had dirty nails and had not been shaved. Another relative said they could not always go home and have “peace of mind” that their relative would be properly cared for, they said it depended on which staff were on duty. The care plans for wound care showed that the wounds are assessed, measured, and graded. The home has a pressure sore treatment protocol and nurses said that any wound that is Grade 2 or is not healing is referred to the Tissue Viability nurse specialist. The records showed evidence of involvement by the Tissue Viability nurse. The records also showed involvement of other professionals such as GP’s, Macmillan nurses, the heart nurse specialist, dieticians, and physiotherapists. The records show that some people have been involved in planning and reviewing care. The majority of relatives were satisfied that they were kept well informed. The home has identified that some people were not aware of system for care reviews and information about this has been included in the newsletter. The home provides care for people with terminal illnesses and uses the Liverpool Care Pathway. This is a recognised model of good practice for palliative care and helps to make sure that the needs of the dying person and their family/friends are dealt with in a sensitive and consistent way. The deputy manager said that they home gets very good support from the community palliative care team. Medicines are stored, managed, and disposed of safely. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home offers a variety of social and leisure activities and people living in the home are given the opportunity to be involved in planning the programme of events. People are supported in keeping in touch with family and friends. EVIDENCE: The home now has an activities organiser. Information about planned events is displayed in the home and is included in the newsletter. People are consulted about what they would like to do. There is some information in the care records about people’s social, cultural, and religious needs. The manager is aware this needs to be linked to the social care plans, which the activities organiser is developing. Church services are held in the home for people of Christian faiths. Overall people were satisfied with the range of activities provided, some people said they would like to go out more. The manager said this is being organised, the home has access to a minibus based at a home in Leeds. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 14 One person said, “They are very friendly and always happy to take the time to talk to us. They arrange a lot of activities and involve us in whatever is going on” One person recently celebrated their 100th birthday and said they enjoyed it very much. Daily routines are flexible and people can stay in their rooms if they choose not to use the communal areas. There are no restrictions on visiting. A new system for menu planning has just been introduced. The system makes it possible to measure the nutritional content and offer a menu that has an ideal nutritional value to meet the needs of people living in the home. The menu is designed to meet the nutritional needs of a person aged 75, the average age of people living in the home. The menus can then be adjusted to take account of people’s preferences. It means a lot more home cooking and more fresh vegetables are used, e.g. all the soups are now home made. The chef said people would still have a choice but this meant he could be sure they were given the opportunity to have a nutritionally balanced diet. The initial response from people was positive. Staff said they had noticed a difference and the food looked much more appetising. The meals served while I was in the home looked appetising and people enjoyed them. There are menus on the tables giving details of each meal including breakfast and supper. I saw staff asking people about what they wanted for their meals the next day. One person who had not been very happy with the food said she was talking to the chef about how the new menu would fit with her dietary needs. When people have their meals on trays all the meal is served at the same time, main course, pudding and hot drinks. This could mean that some parts of the meal were cold when people were ready for them. The manager said she would review this. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. All the required policies and procedures are in place to make sure that complaints are dealt with appropriately and that people are protected from abuse. However, the experience of some people using the service is that their concerns are not acted on, people are not adequately protected, and people’s rights are not respected. EVIDENCE: The complaints procedure is displayed in the entrance hall. Complaints are recorded and reviewed by the area manager. Most people were aware of how to make a complaint; one person said, “If it was necessary to make a complaint I know who to deal with”. We received one complaint about the home; it was referred back to the company and dealt with by the area manager. Another concern was referred to the Adult Protection unit in Bradford and this has been resolved satisfactorily. We asked people if the home responded appropriately when they raised concerns, of the eight who replied three said the home always responded appropriately. Two people said they were reluctant to make complaints because they were worried about the repercussions for people living in the home. Another person said they spoken to the manager about the attitudes of Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 16 some staff but nothing had been done about it. He said he felt some staff thought he was being difficult and didn’t like him visiting because he complained. The home has the required procedures for dealing with adult protection issues. When the company took over they provided training for all staff on the protection of vulnerable adult and on customer services. New staff have training on adult protection during induction and the company requires all staff to have an update every year. Staff were able to give examples of how people’s rights could be abused by poor care practices and were able to say how they would report concerns. However, there were some concerns that people were not always treated with respect. One person said “The attitude of some staff leaves a lot to be desired, particularly when one patient had clearly soiled herself, and was told to get changed, while at least 4 of the staff were sat around watching TV or just lounging about”. Another person said “ I am not very happy with the language (swearing) that some of the staff use, I do not like the carers to speak their own language when they are with me, as I think they should speak English. There is no call to ridicule residents the way some of the carers do; we are not here to be made fun of. If they don’t like it then they are in the wrong jobs.” Other people said they had witnessed people being ignored when they asked for the toilet and heard people being told they did not need to go to the toilet because they were wearing pads. One person said that the way some staff treated people was “degrading” and felt there was a lack of staff supervision. People said some of the staff were “very good” and one person said “The care home respects Mum and that I think is one of the most important things”. Other people said some staff were not very caring in the way they treated people and did not seem to have the right attitude for care work. The manager said she had already spoken to staff about excluding people by speaking in a language they do not understand. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 & 26. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People benefit from living in a home that is well equipped to meet their needs and is safe and well maintained. However, it is not always a pleasant place to live because it is not always clean and free of unpleasant odours. People’s dignity is compromised because not enough care is taken with their personal clothing. EVIDENCE: A number of people mentioned that the home is not as clean as it could be, or used to be, and that sometimes there is an unpleasant smell. The first floor lounge/dining room was decorated but the armchairs were not replaced and many of them have an unpleasant odour. There was an unpleasant odour in this room on both days I visited the home. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 18 The stainless steel cupboards in the kitchenette area of the dining room (on the first floor) do not help to create a homely environment. This area was not very clean, for example there was a line of grime under the fridge door where it was not cleaned when the floor was washed. Relatives said they had seen staff empty cleaning buckets into this sink and they were concerned that crockery and cutlery were sometimes washed in there instead of being taken downstairs and washed properly in the dishwasher. A decked patio has been built outside the dining room on the ground floor and provides a pleasant and safe place for people to sit outside. Work is due to start on the ground floor to create an enclosed smoking room for people. Work has started on redecorating the bathrooms. Some of the bathroom doors do not have locks or the locks are broken, this compromises people’s privacy. Some of the bedrooms are starting to show signs of wear and tear; the manager said they were being refurbished as they became vacant. Most people had lots of their personal belongings around them and some people have private telephones in their rooms. Door locks are fitted to all the bedroom doors and some people have keys their rooms. The home is well equipped to meet the needs of people with physical disabilities, there is a passenger lift to all floors, and the corridors are wide. There are assisted bathing facilities, disabled access toilets and there are hoists to help people with moving and handling. A number of people mentioned concerns about the laundry, particularly about the way people’s personal clothing is dealt with. People said clothes are not ironed, cardigans are shrunk or stretched out of shape, and clothes are not put away tidily. I saw evidence of this and staff confirmed that they do not iron personal clothing. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s needs are not always met in a timely way and they are not always treated with kindness and respect. People are protected by good recruitment procedures. The company provides a very good range of training opportunities for staff. More needs to be done to support staff in applying the training to practice so that people living in the home can benefit from being cared for by a skilled and competent workforce. EVIDENCE: The home works with 2 teams of staff, one for the ground and lower ground floor and one for the first floor. During the day there is always at least one nurse on each floor. The deputy manager has some supernumerary time and the manager is fully supernumerary. The ground floor usually has 5 care assistants during the morning and 3 during the afternoon and evening. Sometimes there is another care assistant from 4pm to 9pm. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 20 The first floor usually has 4 care assistants during the morning and 3 during the afternoon evening. Staff on the first floor said they used to have 5 care staff on the morning shift and they had more time to spend with people. At night there are a total of 5 or 6 staff on duty, usually there are 2 nurses. The home also employs an activities organiser, a maintenance person, and administrative, catering, and housekeeping staff. Some people were concerned there was not enough housekeeping staff to keep the home clean. People’s views about the availability of staff were mixed, some people said staff were readily available when they were needed them, others said they had to wait. One person said “Just on occasions they seem a little overworked or a little busy to respond to an elderly person as quickly as I think they should.” Other people said some staff did not respond to people’s requests for help. Some people said the staff were caring, one person said, “The care assistants are always very kind to my mother and other residents”. However, other people said some staff did not treat people kindly or with respect. I looked at three staff files. The records showed that all the required checks are completed before new staff start work in the home. The CRB (Criminal Records Bureau) checks are done at the company’s head office; the files contained written confirmation that the checks had been completed. All new staff have induction training, the training given to care staff meets the Skills for Care standards. These are nationally recognised standards designed to help new staff get the knowledge and skills they need to care for people. There is an ongoing programme of NVQ (National Vocational Qualification) training. 44 of care staff have an NVQ at level 2 or above and 5 more staff are doing NVQ training. Every member of staff has an individual training file showing what training they have done. The manager was working on a new training matrix, which will form the basis of the training plan and will flag up when training updates are due. The company has a comprehensive list of mandatory training, including fire safety, moving & handling, infection control, adult protection, customer care, and care planning. The records showed that training has also taken place on subjects such as palliative care, the prevention of falls and staff attitudes. Staff have regular appraisals and supervision takes place approximately every two months. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are good systems in place to make sure the home is well managed. However, more needs to be done to deal with the inconsistencies in the way care is delivered and to make sure that people’s concerns are listened to and acted on. EVIDENCE: The manager is a nurse with twenty-five years relevant experience. Since the home was taken over by Southern Cross she has had more opportunities to attend training. The company has systems in place to support the home manager in her role, for example there is a central personnel department, and an area manager visits the home at least once a month. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 22 The company sends questionnaires to people who use the service at least once a year. The replies go to the company’s head office where they are analysed. The area manager then discusses the findings with the home manager and an action plan is put in place to deal with any issues that have been identified. Questionnaires were sent in January 2007. A number of common themes were identified and information on these has been included in the May newsletter. For example the newsletter now has information about residents/relatives meetings because some people said they were not aware that these meetings took place. In some cases people are seen individually to discuss concerns. The comments received from people are also discussed in staff meetings. The home is working towards promoting an open culture that encourages people to express their views of the service. For example the newsletter also has information on how to contact the manager and on the “managers surgery” which is held every month. A number of people made positive comments about the management approach and one person said, “Howgate House appears to be a well run home and friendly nursing home. The managerial staff are always on hand to answer any queries”. Some people said they did not feel they were kept well informed and did not feel confident that they could approach the management team with their concerns. The home manages pension money on behalf of four people. This is a longstanding arrangement and the home no longer gets involved in dealing with people’s personal finances. The records are clear, all transactions are listed, and receipts are kept. The area manager audits a random sample of records and money every month. The maintenance records were up to date and showed that equipment is maintained and serviced at the required intervals. There is system in place for recording and monitoring accidents. The home has a health and safety group that meets every 3 months. Part of this group’s responsibility is to review all accidents and look at how they can reduce the risk of similar incidents happening again. Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 2 2 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 2 3 3 X 3 X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 3 3 3 Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Na/ new service. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The care plans must set out in detail the actions to be taken by staff to deal with people’s personal and health care needs so that people’s needs are not overlooked. Complaints must be fully investigated and acted on and people must be informed of the outcome. This will help people to have confidence that their concerns are taken seriously. People living in the home must be protected from abuse, whether this is by act or omission. Requests for help must be dealt with promptly and people must be spoken to and treated in a respectful way. The home must be kept clean and free of unpleasant odours so that it is a pleasant place for people to live. More care must be taken with people’s personal clothing so that their dignity is respected. The team leaders on all shifts must be suitably qualified, DS0000068594.V336031.R01.S.doc Timescale for action 28/09/07 2 OP16 22 28/09/07 3 OP18 13(6) 28/09/07 4 OP26 16(2)(k) 28/09/07 5 6 OP26 OP27 16(2)(e) 18 28/09/07 28/09/07 Howgate House Version 5.2 Page 25 experienced, and skilled to direct the staff team and organise the delivery of care so that people’s care needs are met consistently and their dignity is respected. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Howgate House DS0000068594.V336031.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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